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Doctors, Insurers Disagree on Workers' Compensation Law

Posted on in Workers' Compensation

Doctors, Insurers Disagree on Workers' Compensation LawThe Illinois House of Representatives and Senate have passed a bill that would amend rules regarding how workers’ compensation insurers pay the healthcare providers who treat the workers’ injuries. There are three main components to the bill:

  • Insurance companies would be required to use electronic filing for workers’ compensation claims with doctors;
  • Insurance companies would need to send an explanation of benefits to doctors when the companies do not authorize medical treatment; and
  • Doctors would be allowed to file a claim in court to collect interest from insurance companies for late medical bills.

Illinois Gov. Bruce Rauner must decide whether to sign or veto the bill, though he often sides with employers on workers’ compensation issues. Doctors claim that the current system could limit the workers’ ability to receive medical treatments, but employers and insurance companies argue that the new law would increase costs for them.

Doctors’ Argument

State healthcare professional organizations say that there is a crisis of unpaid workers’ compensation medical bills. The organizations accuse the insurers of using the paper filing process to delay paying for medical treatments until the workers’ compensation case has been decided, which can take years. They claim that an increasing number of healthcare professionals may stop treating workers’ compensation patients because of the uncertainty of when they will be paid. Illinois already has a law that requires insurers to use electronic filing, but the new law would enforce it by fining insurers who do not comply. Electronic filing would make the claims process quicker and more efficient.

Insurers’ Argument

Employers and insurers often complain that workers’ compensation costs in Illinois are too expensive and believe this new bill would increase that expense. They disagree with the need for the fines that would be issued for not complying with electronic filing. They also say that the law will lead to more healthcare professionals using litigation against them. This would be more costly for them because of the expense of the court case and the delay in closing the claim with the Illinois Workers’ Compensation Commission.

Workers’ Perspective

When you suffer a work-related injury, your priorities are getting treatment for that injury and receiving workers' compensation coverage to protect you against high medical bills and lost income from work. Whatever disagreements your doctor and the insurer have, you do not want it to interfere with these priorities. A McHenry County workers’ compensation attorney at Botto Gilbert Lancaster, PC, can help you file a workers’ compensation claim and fight objections from your employer and its insurer. To schedule a free consultation, call 815-338-3838.



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